Correlation of tape location and tension with surgical outcome after transobturator suburethral tape procedures

Abstract

Objective To explore, using 4D ultrasound, the importance of location and tension of transobturator suburethral tape (TOT) with respect to surgical outcome. Methods

Matched-pair analyses of resting and dynamic morphology between Monarc and TVT-O procedures by ultrasound

“…All 128 women had a negative cough stress test, which was performed with the patient standing, while ensuring by ultrasound that the bladder volume was approximately 200-300 ml [15]. Of the 60 identified women, the mean age was 58 AE 12 years, median parity was 3, mean body mass index (BMI) was 25.2 AE 3.8 kg/m 2 , 34 (56.6%) women were postmenopausal, and two (3.3%) had undergone cesarean section previously.…”

“…The associations between a shorter aTUD or a smaller aUCEA measured at the TOT center and findings suggestive of a more tape tension on the urethra have been reported [15]. The measurements of aTUD and aUCEA at three equidistant tape locations have been reported reliable in resting, straining, and coughing [16].…”

“…ultrasound studies have surveyed the tape functionality at a single TOT location in the sagittal plane [8,13,15,18,19]. Significantly different rates of resting urethral encroachment, defined as the presence of an indentation in the urethral outer wall by the tape, with a plateau-like elevation of the inner wall and narrowing of the echolucent urethral core in the sagittal plane, between Monarc and TVT-O procedures (25.4% vs. 48.3%) have been reported [7].…”

Tomographic Ultrasound Imaging to Control the Placement of Tension-Free Transobturator Tape in Female Urinary Stress Incontinence

“…Multiple studies [2–9] have determined the position of the tape as one relevant factor impacting the surgical outcome. Some works, however, negate such relevance [10, 11].…”

“…Various approaches for measuring the position of the tape by means of ultrasound have been proposed in the literature. These ultrasound parameters comprise, among others, the tape-symphysis pubis angle and distance [2, 11, 12] and the position of the tape in relation to the urethral length measured on midsagittal plane [2, 4–8, 11]. …”